CBD and epilepsy as well as cannabidiol and seizure disorders have been a topic of study for quite some time. Cannabidiol still remains a hot topic of interest today.
Why is CBD of such interest today? Because antiseizure and antiepileptic drugs seem to have little effect or have severe adverse side effects.
The following is a list if studies on CBD and epilepsy, also CBD and seizures, and they are listed from latest to oldest. Some of these studies date back to 1977. That was just 13 years after the structure of cannabidiol was first uncovered.
If you are new to CBD and cannabinoids, you may want to take a look at this article – Cannabinoids – What Are They and What is CBD?
CBD Treatment for Refractory Seizures in Sturge-Weber Syndrome.
Jun 2017 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/28454984]
Brief summary:
The aim of this study was to see what effect, if any, cannabidiol had on Sturge -Weber Syndrome – a neurological disorder marked by a distinctive port-wine stain (birthmark) on the forehead, scalp, or around the eye.
Five subjects with treatment-resistant epilepsy were enrolled and many parameters were measures including: seizure frequency and adverse effects.
Results were that all 5 subjects had at the last visit a greater than 50% seizure reduction, reported an improved quality of life, and remained on cannabidiol 63-80 weeks after starting the drug.
end study summary
Could Cannabidiol be a Treatment Option for Intractable Childhood and Adolescent Epilepsy?
Jun 2017 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/28775950]
Brief summary:
This review looked at multiple studies and gives an overview of where CBD and epilepsy treatment stand and what is required going forward.
An interesting fact coming out of this review was the dosages given to treat epilepsy. In many studies, CBD was added to a baseline anti-epileptic drugs at an initial dose of 2–5 mg/kg/day divided into two doses. CBD dose was increased by 2–5 mg/kg once a week until intolerance or to reach a maximal dose of 25 mg/kg/day. Some studies increased the does to 50 mg/kg/day. The average of dose of CBD was 200–300 mg/day.
The review concludes that little is known about how CBD works in relation to epilepsy and needs to be investigated further. Also, some concern was shown as to the possible placebo effect of CBD considering all the media attention it has received.
Other conclusions were that several studies have shown that CBD does have effectiveness for the treatment of epilepsy. Adverse effects of CBD, that were reported, were mostly mild, including drowsiness, diarrhea, and decreased appetite.
end study summary
Pharmacology of cannabinoids in the treatment of epilepsy
May 2017 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/28087250]
Brief summary:
This review details the studies on treatment of epilepsy with CBD and all the mechanisms that were tested and uncovered. It describes the absorption, distribution, metabolism, and excretion of compounds related to these studies.
Some discussion is given to the interaction of THC and CBD and the anticonvulsant properties of these together.
end study summary
Protective Effects of Cannabidiol against Seizures and Neuronal Death in a Rat Model of Mesial Temporal Lobe Epilepsy.
Mar 2017 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/28367124]
Brief summary:
The target of this study was to evaluate the effects of cannabidiol in the pilocarpine-induced epileptic type seizures in a rat model – pilocarpine is a drug known to induce seizures when injected.
One group of rats was given CBD before any injections. Another group was not given CBD. Injections of pilocarpine were administered and the two groups compared over a few days.
The CBD group demonstrated decreased severity of seizures and seizure related conditions. And the CBD group also showed decreased neurodegeneration.
“Our findings demonstrate anticonvulsant and neuroprotective effects of CBD preventive treatment in the intrahippocampal pilocarpine epilepsy model, either as single or multiple administrations, reinforcing the potential role of CBD in the treatment of epileptic disorders.” – direct quote.
end study summary
Report from a Survey of Parents Regarding the Use of Cannabidiol in Mexican Children with Refractory Epilepsy.
Jun 2017 | Survey Report | [https://www.ncbi.nlm.nih.gov/pubmed/28392943]
Brief summary:
A survey, an online survey, was conducted to find out more about the experiences of parents with children with epilepsy.
53 cases were reviewed with children between 9 months and 18 years of age. All cases were from either Mexico or Latin American countries.
“The parents reported a decrease in convulsions when cannabidiol was used in 81.3% of the cases; a moderate to significant decrease occurred in 51% of cases, and 16% of cases were free from seizure. The number of antiepileptic drugs being used was reduced in 9/43 (20.9%) cases. No serious adverse effects were reported, with only some mild adverse effects, such as increased appetite or changes in sleep patterns” – direct quote.
end study summary
Therapeutic effects of cannabinoids in animal models of seizures, epilepsy, epileptogenesis, and epilepsy related neuroprotection.
May 2017 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/28190698]
Brief summary:
This review surveyed the literature for reports of plant cannabinoid effects with respect to convulsive disorders and critically reviewed the findings.
With some cannabinoids evaluated by the studies reviewed, when the interaction between cannabinoids and receptors are examined in more complex models of epilepsy, epileptogenesis and neuroprotection, a less understood and possibly conflicting model emerges.
However, the effects of cannabidiol (CBD) and cannabidivarin (CBDV), in models of seizures, epilepsy, epileptogenesis, and neuroprotection are less ambiguous, and consistent with reports of therapeutically beneficial effects – as illustrated by the image above. Some caution is shown for the continued need for research in this area is needed in order to identify as yet under-exploited targets for drug development and to raise our understanding of treatment-resistant epilepsies.
end study summary
Cannabidiol Post-Treatment Alleviates Rat Epileptic-Related Behaviors and Activates Hippocampal Cell Autophagy Pathway Along with Antioxidant Defense in Chronic Phase of Pilocarpine-Induced Seizure.
Apr 2016 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/26738731]
Brief summary:
The aim of this study was to examine and score several of the conditions of chronic epilepsy when CBD was given in animal models. Epileptic conditions were brought on by pilocarpine, a drug known to induce seizures, after CBD was given as a pre-treatment.
Cannabidiol was shown to delay the chronic phase of epilepsy. Single administration of cannabidiol during the chronic phase of seizure significantly diminished seizure scores and increased enzyme activity and improved glutathione (an antioxidant) content.
“Results suggest that post-treatment of Cannabidiol could enhance the induction of autophagy pathway and antioxidant defense in the chronic phase of epilepsy, which could be considered as the protective mechanisms of cannabidiol” – direct quote.
end study summary
Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders.
Jun 2014 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/24854329]
Brief summary:
This summary paper goes into some detail regarding the history of cannabis to treat epileptic seizures and then cannabidiol in later studies and clinical trials. The pharmacology, what the compound is and what it does, is reviewed as well.
Interesting points brought out in this paper were; early clinical trials in the 1970’s to the 1990’s; unique perspective on how CBD works.
The conclusion was that there needs to be a double blind clinical trial with a larger number of participants.
end study summary
Epilepsy is the most common neurological disorder, with over 50 million people affected worldwide.
Cannabis, CBD, and epilepsy – From receptors to clinical response.
Dec 2014 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/25282526]
Brief summary:
A review of studies related to high CBD and low THC ratio treatments show that there is a synergy or “entourage effect” between THC and CBD. Treatments are shown to be effective, but the mechanisms of how they work together is not clear and should be studied further.
end study summary
Seizing an opportunity for the endocannabinoid system.
Sep 2014 | Article | [https://www.ncbi.nlm.nih.gov/pubmed/25346637]
Brief summary:
This article addresses the question and possibility that our internal cannabinoid system is, or can be, influenced by external cannabinoids (like CBD) to good effect, but not always. An interesting and insightful article.
end study summary
The non-psychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate and desensitize transient receptor potential vanilloid 1 (TRPV1) channels in vitro: potential for the treatment of neuronal hyperexcitability
Nov 2014 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/25029033]
Brief summary:
A complex description of a study looking at whether the specific cannabinoid receptor TRPV1 (vanilloid) contributes to the epileptic scenario.
When analyzed in lab cultures under various different conditions, the results showed that CBD and CBDV activate and rapidly desensitize TRPV1. CBDV also reduced both epileptiform burst amplitude and duration when tested.
end study summary
Cannabidivarin (CBDV) suppresses pentylenetetrazole (PTZ)-induced increases in epilepsy-related gene expression.
Nov 2013 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/24282673]
Brief summary:
The study focuses on CBDV (cannabidivarin), a naturally occurring cannabinoid similar in structure to CBD, and confirming at a molecular level its effect on seizures.
Seizures induced by pentylenetetrazole in animal subjects were divided into two groups, CBDV treated, and non treated. CBDV significantly decreased pentylenetetrazole-induced seizure severity and increased latency (delay) to the first sign of seizure. Furthermore, there were correlations between reductions of seizure severity and gene expressions (confirmation of activity at a molecular level) in the majority of brain regions in the CBDV treated group.
These results provide the first molecular confirmation of the effects of CBDV upon chemically-induced seizures and underscore its suitability for clinical development.
end study summary
CBD for children with Dravet’s and intractable seizures.
Feb 2013 | Case Study | []
Brief summary:
end study summary
CBDV (cannabidivarin): a naturally occurring cannabinoid – similar in structure to CBD
Report of a parent survey of CBD-enriched cannabis use in pediatric treatment-resistant epilepsy.
Dec 2013 | Survey Report | [https://www.ncbi.nlm.nih.gov/pubmed/24237632]
Brief summary:
A survey was conducted of parents in a Facebook group that were treating their children with cannabidiol for epilepsy.
19 participants met the survey criteria. In the group, a total of 12 anti-epileptic drugs had been tried prior to CBD use.
“Sixteen (84%) of the 19 parents reported a reduction in their child’s seizure frequency while taking cannabidiol-enriched cannabis. Of these, two (11%) reported complete seizure freedom, eight (42%) reported a greater than 80% reduction in seizure frequency, and six (32%) reported a 25-60% seizure reduction. Other beneficial effects included increased alertness, better mood, and improved sleep. Side effects included drowsiness and fatigue.” – direct quote.
The survey showed that parents were using cannabidiol-enriched cannabis as a treatment for their children with treatment-resistant epilepsy – as opposed to a strictly non-THC cannabidiol product.
end study summary
Cannabidiol in Humans—The Quest for Therapeutic Targets
May 2012 | Review paper | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763649/]
Brief summary:
This review searched for studies involving human trials, both healthy and disease related.
It found some conflicting data on whether CBD inhibits or enhances the effects of THC when both are administered – for those trials addressing that aspect.
“Finally, preliminary clinical trials suggest that high-dose oral CBD (150–600 mg/d) may exert a therapeutic effect for social anxiety disorder, insomnia and epilepsy, but also that it may cause mental sedation.” – direct quote.
end study summary
in vitro: performed or taking place in a test tube, culture dish, or elsewhere outside a living organism
in vivo: performed or taking place in a living organism
Cannabinoids for epilepsy.
Jun 2012 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/22696383]
Brief summary:
This was a review of 4 clinical studies involving cannabidiol to treat epilepsy dating from 1979 to 1990.
This table gives a good overview of the trials and was provided in a later review.
See Table: Clinical Trials of Cannabidiol in Epilepsy
TRE: treatment-resistant epilepsy, TLE: temporal lobe epilepsy, IDD: intellectual/developmental disability
*Frequent convulsions for > = 1year; – 1 GTCSz per week
**One patient transferred from placebo to treatment after 1 month
$12 subjects were divided into two groups, but distribution uncertain
$$Abstract and subsequent book chapter have different N’s (10 and 12)
Conclusions of the author were that no reliable conclusions can be drawn at that time regarding the efficacy of cannabinoids as a treatment for epilepsy – and the safety of long term cannabidiol treatment cannot be reliably assessed.
end study summary
CBD exerts anti-convulsant effects in animal models of temporal lobe and partial seizures.
Jun 2012 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/22520455]
Brief summary:
This study extends the findings of an earlier study on CBD and pentylenetetrazole-induced seizures. It reports the effects of pure CBD in various doses in two more animal subject (mice) seizure models. One of which is the acute pilocarpine model of temporal lobe seizure, the other the penicillin model of partial seizure. Both models are performed in vivo (inside the body) of test subjects.
‘In the pilocarpine model, CBD (all doses) significantly reduced the percentage of animals experiencing the most severe seizures. In the penicillin model, CBD significantly decreased the percentage mortality as a result of seizures; CBD (all doses) also decreased the percentage of animals experiencing the most severe tonic-clonic seizures. ‘ – direct quote.
These results extend the profile of CBD as an anticonvulsant and evidence strongly supports CBD as a therapeutic candidate for treatment of human epilepsies.
end study summary
Cannabidiol displays antiepileptiform and antiseizure properties in vitro and in vivo.
Feb 2010 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/19906779]
Brief summary:
In vitro and in vivo models to test the effectiveness of cannabidiol on seizures was the focus of this study.
The in vitro method involved hippocampus slices and multielectrode array recordings. The in vivo models consisted of two groups of mice subjects using pentylenetetrazole (seizure inducing drug) to induce seizures- one group given CBD and the other as a control.
Results showed that CBD exerted clear anticonvulsant effects with significant decreases in incidence of severe seizures and mortality compared with animal subjects not treated with CBD. Finding suggested that CBD does not utilize the CB1 receptor, suggesting some other receptor mechanism that it works with.
The conclusion was that the potential of CBD as a novel antiepileptic drug was demonstrated.
end study summary
The cannabinoids as potential antiepileptics.
Aug 1981 | Review Paper | [https://www.ncbi.nlm.nih.gov/pubmed/6975285]
Brief summary:
This appears to be a review paper.
The review looks at comparative studies and reaches these conclusions:
CBD is selective in its properties.
Potency varies greatly with species.
Potency difference of CBD may be affected by dispositional difference (the perspective interactions of the brain).
Tolerance to CBD is not prominent.
CBD’s spectrum of activity is different than other prototype drugs.
end study summary
Chronic administration of CBD to healthy volunteers and epileptic patients.
Jun 1980 | Clinical Trial | [https://www.ncbi.nlm.nih.gov/pubmed/7413719]
Brief summary:
n this clinical trial, cannabidiol was given to both; patients suffering epilepsy; and healthy patients.Two phases were implemented.
In phase 1 of the study, 3 mg/kg daily of cannabidiol (CBD) was given for 30 days to 8 health human volunteers. Another 8 volunteers received the same number of identical capsules containing placebo in a double-blind setting. Neurological and physical examinations, blood and urine analysis, ECG and EEG were performed at weekly intervals.
In phase 2 of the study, 15 patients suffering from generalized epilepsy were randomly divided into two groups. Each patient received, in a double-blind procedure, 200-300 mg daily of CBD or placebo. The drugs were administered for along as 4 -1/2 months.
“Clinical and laboratory examinations, EEG and ECG were performed at 15- or 30-day intervals. Throughout the experiment the patients continued to take the antiepileptic drugs prescribed before the experiment, although these drugs no longer controlled the signs of the disease. All patients and volunteers tolerated CBD very well and no signs of toxicity or serious side effects were detected on examination. 4 of the 8 CBD subjects remained almost free of convulsive crises throughout the experiment and 3 other patients demonstrated partial improvement in their clinical condition. CBD was ineffective in 1 patient. The clinical condition of 7 placebo patients remained unchanged whereas the condition of 1 patient clearly improved. “ – direct quote.
end study summary
Cannabidiol–antiepileptic drug comparisons and interactions in experimentally induced seizures in rats.
Apr 1977 | Lab Study | [https://www.ncbi.nlm.nih.gov/pubmed/850145]
Brief summary:
This study compared the effects CBD and many anti-epileptic drugs on rat subjects using electroshock and audiogenic (produced by sound) tests.
CBD was an effective and relatively potent anticonvulsant in both tests. One anti-epileptic drug was shown to increase potency significantly when combined with CBD. It was also shown that CBD reduced the potencies of known convulsant inducers.
Data indicated that CBD was an effective anticonvulsant comparable to clinically effective drugs. And it appears that CBD enhances the effects of some and also reduces the effects other antiepileptic drugs.
end study summary
As you can see from the many studies related to CBD and epilepsy and seizures, CBD has been shown as very effective for treatment of these disorders.
These studies did not just start recently. You may have noticed the studies dating back into the 1980’s. Only recently has public attention been drawn to CBD and how effective it is with many children suffering from epilepsy.
